实现LDL-C目标的挑战:来自意大利SANTORINI研究队列的见解
Marcello Arca1, Paolo Calabrò2, Anna Solini3
1Department of Translational and Precision Medicine, Sapienza, University of Rome, Rome, Italy.
Nutrition, metabolism, and cardiovascular diseases : NMCD
|October 22, 2025
概括
意大利的SANTORINI研究显示,降脂疗法的使用增加,低密度脂蛋白胆固醇 (LDL-C) 的控制更好. 然而,只有三分之一的患者达到LDL-C目标,这表明需要改进心血管疾病风险降低策略.
科学领域:
- 心脏病学 心脏病学
- 脂质代谢 脂质代谢是什么
- 公共卫生 公共卫生
背景情况:
- 心血管疾病 (CVD) 是全球主要的死亡原因,动脉样硬化心血管疾病 (ASCVD) 是主要的贡献者.
- 低密度脂蛋白胆固醇 (LDL-C) 的升高是ASCVD的重要危险因素.
- 更新的欧洲指南建议高风险和非常高风险患者降低LDL-C目标,但许多人没有达到这些目标.
研究的目的:
- 评估SANTORINI研究的意大利队列中的脂质管理策略.
- 评估意大利患者的降脂疗法 (LLT) 一年随访结果.
- 确定在实现指南推的LDL-C目标方面的差距.
主要方法:
- 桑托里尼研究招募了2095名患者,其中1993人完成了1年的随访.
- 收集的数据包括基线和随访脂质水平,LLT使用 (单疗与联合疗法),以及实现LDL-C目标.
- 记录了心血管事件,包括心血管死亡和主要不良心血管事件 (MACE).
主要成果:
- 从基线 (32%未接受治疗) 到随访 (2.1%未接受治疗) 时,降脂疗法 (LLT) 的使用显著增加.
- 组合疗法,特别是高强度他类药物和ezetimibe,出现了相当大的增长.
- 总体LDL-C水平从2.5mmol/L降至1.9mmol/L,而达到LDL-C目标的患者比例从20.8%增加到35.0%.
结论:
- 桑托里尼研究的意大利队列在LLT利用和LDL-C管理方面取得了进展,趋向于组合疗法.
- 尽管情况有所改善,但绝大多数患者没有达到指导方针推的LDL-C目标.
- 进一步优化降脂策略对于有效降低心血管风险至关重要.
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